|Numéro de publication||US7112196 B2|
|Type de publication||Octroi|
|Numéro de demande||US 10/686,119|
|Date de publication||26 sept. 2006|
|Date de dépôt||15 oct. 2003|
|Date de priorité||13 juin 2003|
|État de paiement des frais||Payé|
|Autre référence de publication||US20040254569|
|Numéro de publication||10686119, 686119, US 7112196 B2, US 7112196B2, US-B2-7112196, US7112196 B2, US7112196B2|
|Inventeurs||Jared Brosch, Andreas Hadjicostis|
|Cessionnaire d'origine||Piezo Technologies, Inc.|
|Exporter la citation||BiBTeX, EndNote, RefMan|
|Citations de brevets (23), Référencé par (52), Classifications (16), Événements juridiques (4)|
|Liens externes: USPTO, Cession USPTO, Espacenet|
The present application claims the benefit of U.S. Provisional Patent Application No. 60/478,649 filed Jun. 13, 2003, which is hereby incorporated by reference. The present application is related to the commonly owned U.S. Patent Application entitled: “MINIATURE ULTRASONIC PHASED ARRAY FOR INTRACARDIAC AND INTRACAVITY APPLICATIONS” invented by Brosch et al. and filed on even date herewith, and the commonly owned U.S. Patent Application entitled: “COMPOSITIONS FOR HIGH POWER PIEZOELECTRIC CERAMICS” invented by Liufu and filed on even date herewith, all of which are hereby incorporated by reference.
The present invention relates to acoustic energy generation, and more particularly, but not exclusively, relates to the fabrication, use, and structure of devices including an array of elements to generate ultrasonic energy for tissue ablation.
Cardiac arrhythmia, and atrial fibrillation in particular, persist as common and dangerous medical aliments associated with abnormal cardiac chamber wall tissue, and are often observed in elderly patients. In patients with cardiac arrhythmia, abnormal regions of cardiac tissue do not follow the synchronous beating cycle associated with normally conductive tissue in patients with sinus rhythm. Instead, the abnormal regions of tissue aberrantly conduct to adjacent tissues, disrupting the cardiac cycle into an asynchronous rhythm. Such abnormal conduction is known to occur at various regions of the heart.
Irregular cardiac function and corresponding hemodynamic abnormalities caused by atrial fibrillation can result in stroke, heart failure, and other medical problems. Indeed, atrial fibrillation is believed to be a significant cause of cerebral stroke. Specifically, it is theorized that the hemodynamic irregularity resulting from fibrillatory wall motion precipitates thrombus formation within the atrial chamber. A thromboembolism is ultimately dislodged into the left ventricle which thereafter pumps the embolism into the cerebral circulation that can result in a stroke. Accordingly, numerous procedures for treating atrial arrhythmia have been developed, including pharmacological, surgical, and catheter ablation procedures.
Among these, the less invasive catheter-based approaches have generally been targeted to atrial segmentation with ablation catheter devices adapted to form linear or curvilinear lesions in the wall tissue which defines the atrial chambers. Other disclosed approaches provide shaped or steerable guiding sheaves for the purpose of directing tip-ablation catheters toward the posterior left atrial wall such that sequential ablations along the predetermined path of tissue may create the desired lesion. In other approaches, atrial fibrillation is addressed with an ablation device that navigates through the circulatory system to form one or more circumferential lesions in pulmonary vein tissue. Various energy delivery modalities have been disclosed for forming lesions, including use of microwave, laser, thermal conduction, ultrasound, and more commonly radio frequency energies to create conduction blocks. U.S. Pat. Nos. 6,117,101; 6,245,064 B1; 6,254,599 B1; 6,600,174 B1; 6,608,775 B2; 6,514,249 B1; and 6,527,769 B2 provide additional background information concerning various cardiac ablation devices.
Frequently, these and other approaches do not provide a desired degree of control with respect to the targeting of ablation energy on tissue. Furthermore, for ultrasonic generating devices directed to circumferential tissue ablation, the level of power needed to ablate the surrounding tissue can result in heat dissipation problems and/or fracture of ultrasound-generating elements. Thus, there is an ongoing demand for further contributions in this area of technology. Moreover, advances in this area of technology can have application in noncardiac medical treatments and/or in nonmedical procedures.
One embodiment of the present invention is a unique acoustic ablation technique. Other embodiments include unique methods, systems, devices, and apparatus for generating acoustic energy. As used herein, “ultrasound” and “ultrasonic” refer to acoustic energy waveforms having a frequency of more than 20,000 Hertz (Hz) through one or more media at standard temperature and pressure.
A further embodiment of the present invention includes: providing a therapeutic device including an array of elements that each produce acoustic energy when activated, positioning the therapeutic device within a patient's body, and ablating tissue by activating one or more of the elements while the device is within the patient's body. In one form, the array elements are carried on a flexible circuit substrate and are composed of a piezoelectric material suitable to produce ultrasonic energy. For one particular variation of this form, each element produces a maximum acoustic power output of at least one quarter of a watt at a frequency of several megahertz, although other variations may have a different power level and/or frequency range.
Another embodiment includes: providing a therapeutic device with ultrasonic ablation elements fixed in relation to one another and a circumference of the device, positioning the device within a patient's body, and activating different groups of the elements while the device is in the patient's body to correspondingly provide ultrasonic energy focused to ablate different tissue regions.
In still another embodiment, a system includes an ablation device and a control station. The ablation device is operable to be percutaneously placed within a patient's body, and includes a proximal end portion, a distal end portion, and an array of ultrasonic ablation elements located at the distal end portion. These elements may be carried on a flexible substrate. The proximal end portion of the device is coupled to the control station. The control station includes one or more processors operable to selectively activate one or more elements of the array. In one form, operating logic for the station is provided as processor programming instructions stored in memory that is selectively accessed by the one or more processors. In a particular form, these instructions are stored on a removable memory device such as a floppy disk, CD or DVD. The ablation device can include cabling that couples the array to the control station and includes a number of electrical conductors each electrically insulated from one another and each being electrically connected to a different one of the elements. For such forms, the control station can selectively change the focus of ultrasonic energy emanating from the device to ablate different tissue regions while the device is in the patient's body. In one particular arrangement, the control station activates different subsets of the elements in a desired sequence to correspondingly focus ultrasonic energy on different tissue segments circumferentially surrounding the device.
In yet another embodiment, an assembly is provided that includes a rigid piezoelectric member mounted to a flexible circuit substrate. The piezoelectric member is divided into a number of pieces to provide an array of ultrasonic ablation elements, and the flexible circuit substrate is coupled to cabling and the cabling to a connector. The connector includes a number of electrical contacts each insulated from one another and each being electrically connected to a different one of the elements.
A further embodiment includes an apparatus encoded with programming instructions executable by one or more processors to activate different subsets of ultrasonic ablation elements included in an ablation element array in accordance with predefined sequence. For each stage in the sequence, the subset of elements collectively focuses ultrasonic energy on a different circumferential segment of tissue surrounding the array to form a tissue lesion. The apparatus can be in the form of memory storing the instructions, including, but not limited to, a removable memory device, such as a floppy disk, CD, or DVD.
One object of the present invention is to provide a unique ultrasonic ablation technique.
Another object of the present invention is to provide a unique method, system, device, or apparatus for generating acoustic energy.
Further forms, objects, features, aspects, benefits, advantages, and embodiments of the present invention shall become apparent from the detailed description and drawings provided herewith.
For the purpose of promoting an understanding of the principles of the invention, reference will now be made to the embodiments illustrated in the drawings and specific language will be used to describe the same. It will nevertheless be understood that no limitation of the scope of the invention is thereby intended. Any alterations and further modifications in the described embodiments, and any further applications of the principles of the invention as described herein are contemplated as would normally occur to one skilled in the art to which the invention relates.
One embodiment of the present invention includes an ultrasonic device structured for percutaneous insertion in the human body. The device includes an array of piezoelectric elements located at a distal end portion, and cabling connected to the array that extends from the array to a proximal end portion of the device. The elements are carried on a flexible circuit substrate including at least two levels of electrical conductor patterns. The cabling includes multiple conductors each electrically insulated from one another and each electrically connected to a different one of the elements. In one preferred form, the elements number at least eight. In a more preferred form, the elements number at least 32. In a still more preferred form, the elements number at least 64 and are configured to ablate tissue when activated by an appropriate electrical stimulus through the cabling.
Station 30 also includes processing subsystem 40 for processing signals and data associated with system 20. Subsystem 40 includes analog interface circuitry 42, Digital Signal Processor (DSP) 44, data processor 46, and memory 48. Analog interface circuitry 42 is responsive to control signals from DSP 44 to provide corresponding analog stimulus signals to ablation device 60. At least one of analog circuitry 42 and DSP 44 includes one or more digital-to-analog converters (DAC) to facilitate operation of system 20 in the manner to be described in greater detail hereinafter. Processor 46 is coupled to DSP 44 to bidirectionally communicate therewith, selectively provide output to display device 34, and selectively respond to input from operator input devices 32.
DSP 44 and/or processor 46 can be of a programmable type; a dedicated, hardwired state machine; or a combination of these. DSP 44 and processor 46 perform in accordance with operating logic that can be defined by software programming instructions, firmware, dedicated hardware, a combination of these, or in a different manner as would occur to those skilled in the art. For a programmable form of DSP 44 or processor 46, at least a portion of this operating logic can be defined by instructions stored in memory 48. Programming of DSP 44 and/or processor 46 can be of a standard, static type; an adaptive type provided by neural networking, expert-assisted learning, fuzzy logic, or the like; or a combination of these.
Memory 48 is illustrated in association with processor 46; however, memory 48 can be separate from or at least partially included in one or more of DSP 44 and processor 46. Memory 48 includes at least one Removable Memory Device (RMD) 48 a. Memory 48 can be of a solid-state variety, electromagnetic variety, optical variety, or a combination of these forms. Furthermore, memory 48 and can be volatile, nonvolatile, or a mixture of these types. Memory 48 can be at least partially integrated with circuitry 42, DSP 44, and/or processor 46. RMD 48 a can be a floppy disc, cartridge, or tape form of removable electromagnetic recording media; an optical disc, such as a CD or DVD type; an electrically reprogrammable solid-state type of nonvolatile memory, and/or such different variety as would occur to those skilled in the art. In still other embodiments, RMD 48 a is absent.
Circuitry 42, DSP 44, and processor 46 can be comprised of one or more components of any type suitable to operate as described herein. Further, it should be appreciated that all or any portion of circuitry 42, DSP 44, and processor 46 can be integrated together in a common device, and/or provided as multiple processing units. For a multiple processing unit form of DSP 44 or processor 46; distributed, pipelined, and/or parallel processing can be utilized as appropriate. In one embodiment, circuitry 42 is provided as one or more components coupled to a dedicated integrated circuit form of DSP 44; processor 46 is provided in the form of one or more general purpose central processing units that interface with DSP 44 over a standard bus connection; and memory 48 includes dedicated memory circuitry integrated within DSP 44 and processor 46, and one or more external memory components including a removable disk form of RMD 48 a. Circuitry 42, DSP 44, and/or processor 46 can include one or more signal filters, limiters, oscillators, format converters (such as DACs or digital-to-analog converters), power supplies, or other signal operators or conditioners as appropriate to operate system 20 in the manner to be described in greater detail hereinafter.
Equipment 50 includes flexible catheter 52 with proximal end 52 a opposite distal end 52 b, and catheter port device 54. Proximal end 52 a is connected to catheter port device 54 to be in fluid communication therewith. Catheter 52 includes one or more lumens extending therethrough. Equipment 50 is introduced into and removed from body B through opening O in a standard manner that typically includes one or more other components not shown to enhance clarity.
Ablation device 60 has proximal end portion 60 a and distal end portion 60 b. Ablation device 60 includes electrical cabling 62 with connector 64 electrically connected to station 30. Cabling 62 extends from connector 64 at proximal end portion 60a through port device 54 and a lumen of catheter 52 to distal end portion 60 b. Ablation device 60 includes ultrasound ablation array assembly 70 and terminates at distal device tip 72. Assembly 70 is connected to cabling 62 at distal end portion 60 b by interface 74.
Further aspects of assembly 70 are illustrated in the partial cut-away, side view of
Referring specifically to
Assembly 70 includes a filling/adhesive material 160 between adjacent elements 150 and cylindrical backing rod member 170 in interior 76. In one embodiment, material 160 is a standard epoxy and member 170 is formed from a thermoplastic and/or thermoset polymeric resin selected to minimize transmission of ultrasonic energy from array 150 a therethrough. In another embodiment, the same composition is used for both material 160 and member 170. In still other embodiments, one or more other materials or backing structures are used in interior 76 of assembly 70 between elements 150 as would occur to those skilled in the art.
Referring generally to
After placement of catheter 52, ablation device 60 is inserted through port device 54 and a lumen of catheter 52 and is slidingly advanced towards distal end 52 b. Advancement of distal end portion 60 b continues in this manner until assembly 70 emerges from distal end 52 b and reaches a desired position within pulmonary vein PV. During these operations, one or more standard imaging devices can be utilized to visualize the position of catheter 52 and assembly 70. For materials used in equipment 50 or device 60 that are transparent or translucent to a selected imaging technique (such as polymeric resins that are generally transparent to x-ray based imaging), a marker that is opaque to such imaging technique can be included in catheter 52 and/or assembly 70 to aid with visualization. In one embodiment, distal end portion 60 b of device 60 is sized to readily slide through a 7-French catheter (2 millimeter outer diameter) positioned in heart H of body B in such a manner. Device 60 can optionally include one or more position sensing devices of the type described, for example, in U.S. Pat. No. 6,514,249 B1 to Maguire et al. In one particular form of this option, one or more of elements 150 are utilized to sense position of assembly 70 relative to surrounding tissue of body B.
After positioning, array 150 a of device 60 is controllably activated with station 30 to selectively ablate tissue by application of acoustic power from one or more of elements 150 in the ultrasonic range. For one preferred form, each element 150 is operable to output a maximum acoustic power of at least about 0.25 watt. In a more preferred form, each element 150 is operable to output a maximum acoustic power of 2 watts or more.
For this specific embodiment, circuitry 42 can include a DSP-controllable function generator that provides an oscillatory electrical input to a phase shift stage. This phase shift stage includes a number of active, all-pass filters adjusted to provide different phase outputs in relation to one another, where the number of outputs desired corresponds to the number of differently phased elements 150 in an activated subset. For one form, eight differently phased outputs are provided—one for every two elements 150 of a sixteen member subset to provide symmetry about the focal axis FR. The phase-shifted signals are provided to DSP-controlled preamplifiers in a subsequent preamplification stage to account for any gain/loss changes that may have occurred during the all-pass filtering in the phase shift stage. The outputs of the preamplifiers are provided to high-frequency amplifiers in a subsequent amplification stage to amplify the signals from the preamplifiers by a fixed amount of gain. The final output gain can be controlled with the function generator and/or preamplifiers. To provide for sequential activation of different subsets, the outputs of the amplifiers can be coupled to different elements 150 by way of one or more DSP-controlled switching matrices or trees included in circuitry 42.
In other embodiments, circuitry 42 can be differently configured, including arrangements to select between different subset quantities, relative phase relationships, amplification, and the like. In alternative forms, the activation pattern can sweep clockwise and/or include a different number of subset elements. In still other embodiments, the subset element quantity may vary from one subset to the next, subsets may be sequenced in a pattern that lacks a rotational progression, subsets may be constituted of nonconsecutive elements 150 (such that one or more elements are skipped or activated out of consecutive order), more than one element 150 may be activated or deactivated at the same time, a change from one activated subset to another activated subset may not include any of the same elements 150, and/or elements 150 may be active only one at a time. Additionally or alternatively, system 20 can be used to provide ablation treatment for other medical conditions and/or other types of tissue. For any of these variations, subsystem 40 can be correspondingly configured.
In further embodiments directed to ablation of tissues by navigation through the circulatory system and/or other body passageways, device 60 can be arranged with a longitudinal channel or passage to receive a guide wire. Guide wire placement is typically performed in advance of catheter 52. With an appropriate guide wire passageway, device 60 can be slidably advanced along a previously placed guide wire with or without utilization of catheter 52. Alternatively or additionally, device 60 can be of a self-directing, steerable variety that does not require a catheter or guide wire to navigate body passageways to a target site within the patient.
Referring additionally to
Column 204 b icons of region 204 can be selected with pointer 202 to decrease the property indicated by the column 204 a label in the same row. Column 204 c icons can be selected with pointer 202 to increase the property indicated by the column 204 a label in the same row. Column 204 d displays the current value of the property indicated by the column 204 a label in the same row, showing the units of the corresponding property in parentheses. It should be understood that in other arrangements, different frequencies and/or different power levels may be applied among different elements 150 at the same time. Alternatively or additionally, more than one element or group of elements may be activated at the same time corresponding to different relative positions and optionally different focal lengths. The arrangement of region 204 can be readily adjusted to account for such variations if desired.
System control region 206 includes buttons that can be selected with pointer 202 to cause the action indicated by the corresponding label. Data field 208 provides multiple lines of alphanumeric text regarding the patient undergoing the procedure. Region 210 provides a visual representation of array 150 a relative to the surrounding tissue of pulmonary vein PV. In one form, some or all of region 210 is a window that shows an image of distal end portion 60 b during use with or without overlays corresponding to focal information and active elements. Such an image can be provided from imaging equipment coupled to or integrated in station 30. Station 30 can be arranged to show other information under control of the operator and further includes a control (such as one or more buttons or the like) for an operator to direct the activation of elements 150 in accordance with a given sequence and/or to step through different activation sequence steps. Further, station 30 can include limits on its operation to prevent improper use and/or can monitor one or more physiological aspects of the patient to accordingly adjust operation with or without operator intervention.
Turning next to the flowchart of
Side 80 a of
Side 80 b of
In this component form of substrate 80, pads 84, 86, 92, and 102 are provided in the form of exposed metallization. Typically, this metallization includes a noble metal such as copper, gold, platinum, or silver or an alloy thereof, that is plated and/or tinned to facilitate soldering. Generally, patterns 88 and 108, including vias 120 and 124 on side 80 b are otherwise covered by an electrically nonconductive material. This material is typically in the form of a film or coating of a translucent or transparent polymeric resin, but can be comprised of one or more different materials as would occur to those skilled in the art. Alternatively some or all of such patterns may not be covered by an insulating material at this stage.
Referring to the flowchart of
In addition, such piezoceramics can include one or more dopant materials, which are not reflected in the above formula. Examples of dopants include manganese, niobium, tellurium, molybdenum, tantalum, and yttrium ceramics, more preferable the dopants include one or more of the following: MnO2, Ni2O3, TeO2, MoO3, Nb2O5, Ta2O5, and Y2O3. In one preferred approach, one or more of the dopants are added to the piezoceramics in individual amounts up to about 2 weight percent (wt %), based upon the total weight of the piezoceramic. One preferred composition includes up to about 0.2 wt % MnO2, based upon the total weight of the resulting ceramic. Another preferred composition includes up to about 1.6 wt % Nb2O5.
These piezoceramics can be prepared by slurrying the selected powdered metal oxides in a liquid such as water or an alcohol. The suspended powder is pulverized in a ball mill until the resulting mixed slurry is homogeneous and has a sufficiently small particle size. The resulting pulverized mixture is dried, preferably in an oven at elevated temperatures between about 100 and 150° C.
The resulting powder is thermally treated or calcined to form the desired perovskite structure. Preferably, the pulverized powder is heated to a temperature less than about 1000° C., more preferably to a temperature between about 900° C. to about 1000° C., still more preferably between about 925° C. and about 975° C. The powder is slowly heated to the selected temperature over a period of time. The heating rate can be varied considering the powder mass, the components in the powder, and the desired application for the final piezoceramic component. Preferably the powder is heated at a rate between about 100° C. and about 220° C. per hour, more preferably at a rate of between about 125° C. and 200° C. per hour, still more preferably at a rate of between about 150° C. and 190° C. per hour. Thereafter, the powder is held at that the high temperature for a time period. Again the hold time can be varied depending on the mass, identity and amount of the components in the powder. Typically the powder is held at the high temperature for a time period between about 1 and about 10 hours, more preferably between about 2 and about 6 hours. After this thermal treatment, the powder is allowed to cool back to room temperature.
The calcined powder is re-pulverized in a ball mill as has been described above, and then dried. This repulverized ceramic is then blended or suspended in a binder to provide a paste with the pulverized ceramic suspended in the paste. This paste is molded, pressed, or extruded as desired into a shaped article. The binder can be removed from the article either by heating to evaporate or burn-off the binder or, more preferably, by using a solvent to dissolve the binder material. The solvent can be any solvent, preferably an organic solvent into which the binder material exhibits a suitably high solubility. Typical solvents include alcohols, acetone, chloroform, methylene chloride, and other polar organic solvents which exhibit a relatively low boiling point or high vapor pressure.
The green article is then fired at elevated temperature range. The green article is placed in a suitable container such as an aluminum crucible and additional (unmolded) ceramic powder is placed around the shaped article during the firing process. The elevated temperature range can be selected to be between about 900° C. and about 1350° C., more preferably between about 950° C. and about 1300° C. The article can be held at a selected temperature in that temperature range for a time between about 10 and about 25 hours. More preferably, the article is slowly heated through the elevated temperature range at a selected heating rate. The heating rate can be selected by considering the mass or volume of the green article, the constituents in the ceramic and the desired properties of the piezoceramic article. After firing, the article can be cooled to ambient temperature.
For the purpose of promoting further understanding, the following example is provided; however, it should be understood that this example is merely illustrative and not limiting in any fashion. In this nonlimiting example, the following powdered ceramics were combined: PbO, 670.9 g; ZrO2, 95.7; TiO2, 96.1 g; Nb2O5, 121.0 g; MgO, 18.23 g; SrCO3, 28.14; and MnO2, 3.0 g. These powders were then suspended in 900 ml of deionized water and ball milled for about 16 hrs. The resulting powdered slurry was than dried at 130° C. The dried powder was calcined at 950° C. for 3 hours. Thereafter calcined ceramic powder was cooled to ambient temperature. The resulting ceramic was then re-pulverized by suspending in 1000 ml of deionized water and ball milling for 7 hrs. The pulverized ceramic was again dried at 130° C. to evaporate the water. The dried powder was suspended in a 5% polyvinyl alcohol (PVA) solution to provide a paste. This paste was extruded through a 1 7/16″ slotted die under 1500 lb force to form a ceramic billet. This ceramic billet was fired at 1240° C. for 2.5 hours. Thereafter the ceramic billet was cooled to ambient temperature. Silver electrodes were patterned on the ceramic billet according to standard procedures. The resulting billet was then poled (polarized) at 115° C. and 70–80 V/mil for about 10 minutes.
In other embodiments one or more different procedures for making the piezoelectric material and/or one or more different piezoelectric compositions (such as PZT4, PZT8, a composite variety, a single crystal piezoelectric, and/or a piezoelectric polymer just to name a few nonlimiting examples) can be alternatively or additionally utilized for the work piece as would occur to those skilled in the art. Indeed, electrode deposition and poling are described differently than in the above-indicated example in connection with operations 236 b and 238 b hereinafter, to point out just a few other variations.
The work piece for array 150 a is generally shaped in the form of a parallelpiped block of piezoelectric material. The work piece includes two opposing faces sized and shaped generally the same as pad 84 of substrate 80 described in connection with
Procedure 230 b continues with operation 236 b. In operation 236 b, metallization is deposited on the opposing faces of the work piece to provide electrodes.
Procedure 230 b continues with operation 238 b in which the piezoelectric material is poled (polarized). Polarization is provided by subjecting the work piece to: (a) a slow ramp-up to an elevated temperature, (b) a slow ramp-up of a polarizing electric field (voltage) across the electrodes while maintaining the elevated temperature, (c) a slow ramp-down to room temperature while the field is maintained, and (d) a slow ramp down of the electric field while at room temperature. Temperature changes are performed at a rate of about 1 degree C. per minute and voltage changes are gradual to a maximum of about 50–80 volts per mil thickness of material with a dwell time at maximum temperature and voltage of about 5 minutes. Performance parameters of the work piece are tested after poling. After parameter testing, the work piece edge that is designated for placement closest to pad edge 84 a is sanded in operation 239 b. After sanding, the work piece is cleaned in operation 240 b with isopropyl alcohol and an ultrasonic cleaner. The work piece is also etched in a plasma-etching device in operation 242 b. Procedure 230 b then returns to process 220.
From operation 250, process 220 continues with operation 252 in which the electrical connection of mounted work piece 140 is tested. After this testing, an electrically nonconductive bead of epoxy adhesive is place along the edge that was sanded in operation 234 b of procedure 230 b. The deposited epoxy bead is designated as nonconductive support member 144 in the sectional view of
After member 144 has cured, the incomplete assembly is selectively masked, leaving only electrode 152 a of face 151 a, member 144, and ground pad 86 exposed in operation 256. The exposed area after masking corresponds to the rectangular region indicated by line segments 145 a and 145 b in relation to partial assembly 70 a of
In operation 258, electrical connections are tested to verify proper electrical connectivity and isolation, as appropriate. Also, impedance is measured to verify proper electrical connection through the piezoelectric material of mounted work piece 140. From operation 258, process 220 continues with operation 262. In operation 262, mounted work piece 140 is divided into elements 150. In one form, separation of elements 150 is performed with a dicing saw. The dicing saw is aligned relative to the assembly using alignment trace 104 on side 80 a of substrate 80 (the extra trace 104 is used to put the blade in the proper plane, and give the location for the first cut), and then used to cut the mounted work piece 140 into 64 equally sized elements 150. The blade of the saw cuts through metallization 142, piezoelectric body 143, at least a portion of member 144, electrodes 152 a and 152 b, bonding adhesive, pad 84, and at least 5 micrometers into substrate 80 to ensure complete electrical separation of elements 150 from one another and separation of pad 84 into corresponding pieces that are electrically isolated from one another. After separation, each element 150 includes a portion of electrode 151 a electrically connected to metallization 142 and a portion of electrode 151 b connected to a corresponding portion of pad 84 and via 124. Each of vias 124 is sized and positioned to provide electrically isolated interconnection to a different one of conductors 110 on side 80 b of substrate 80 after performance of operation 262.
The partial assembly of
After operation 262, the assembly is tested in operation 264 to verify each of elements 150 is electrically connected to electrical ground at pads 86 and 92 through a portion of electrode 151 a. Testing also verifies that each element 150 is electrically connected to a corresponding signal pad 102 through the electrical connection of corresponding portions of electrode 151 b and pad 84, and a corresponding via 124, conductor 110, and via 120; and that signal pads 102 remain electrically isolated from each other and electrical ground. In this manner, side 80 a predominantly defines traces for electrical ground and side 80 b predominantly defines signal pathways.
From operation 264 (
In operation 272 of procedure 270 a, region 133 is cleaned with isopropyl alcohol. In operation 274, flux is applied to contacts 134. In operation 276, contacts 134 are tinned by a rapidly dipping region 133 in a solder pot of molten Sn60Pb40 solder with a dwell time of less than one second. The solder pot temperature is maintained just a few degrees above the melting point for Sn60Pb40 solder. In other embodiments a different tinning and/or plating procedure can be utilized to accommodate the cable connection operation, or may be absent. After tinning, solder bridges between contacts 134 are removed with a heated small diameter soldering iron tip. Region 133 is cleaned in operation 278. In operation 180, cable 130 is aligned with substrate 80 and taped to substrate 80, registering each of contacts 134 with a respective pad 92 or 102 of the corresponding pad set 100 to which it is to be connected. In operation 282, flux is applied to region 133 and corresponding pads 92 and 102 (
After operation 270, process 220 continues with operation 290. In operation 290, substrate/array assembly is placed in heat-shrink tubing. Heat is applied to the heat-shrink tubing to pre-form substrate 80 into a bent or rolled shape in operation 292. After cooling, the heat-shrink tubing is removed in operation 294. Next the preformed assembly is placed into a clamping fixture in operation 296. From operation 296, process 220 continues with operation 298 in which material 160 (
In other embodiments different ways of shaping, filling, and the like can be used. In still other embodiments one or more of material 160 and member 170 may not be used, and/or a longitudinal passageway through assembly 70 may be formed in member 170 and/or material 160 to receive a guide wire during use. For embodiments directed to ablation in the pulmonary vein region, process 220 can be utilized to provide 64 elements 150 in a unit that is about 6.4 millimeters wide before rolling with each element 150 having a size of about 85 micrometers by 6.5 millimeters, and still provide maximum individual acoustic power levels for each of the elements 150 on the order of one to two watts or more. After rolling or bending, assembly 70 can readily fit through a 7-French catheter. In this arrangement, a 3 millimeter heat shrink tubing is commonly employed for operation 292. In accordance with another embodiment of the present invention, ablation devices with multielement, high power arrays can be provided for catheter sizes in the 3–12 French range. In still other embodiments, some or all of process 220 is utilized to provide ultrasonic element arrays for other applications, including ablation for different procedures, tissue, or material types; ultrasonic sensing and/or imaging; or the like. Alternatively or additionally, the array assembly is formed into a noncylindrical shape or remains in the generally flat, noncylindrical shape shown in
All publications, patents, and patent applications cited in this specification are herein incorporated by reference as if each individual publication, patent, or patent application were specifically and individually indicated to be incorporated by reference and set forth in its entirety herein. Any theory, mechanism of operation, proof, or finding stated herein is meant to further enhance understanding of the present invention and is not intended to make the present invention in any way dependent upon such theory, mechanism of operation, proof, or finding. While the invention has been illustrated and described in detail in the drawings and foregoing description, the same is to be considered as illustrative and not restrictive in character, it being understood that only the selected embodiments have been shown and described and that all changes, modifications, and equivalents of the inventions as defined herein or by the following claims are desired to be protected.
|Brevet cité||Date de dépôt||Date de publication||Déposant||Titre|
|US5091893 *||5 avr. 1990||25 févr. 1992||General Electric Company||Ultrasonic array with a high density of electrical connections|
|US5176142||16 avr. 1991||5 janv. 1993||Hewlett-Packard Company||Endoscopic ultrasound probe with take-up cable mechanism|
|US5323781||19 mai 1993||28 juin 1994||Duke University||Methods for the diagnosis and ablation treatment of ventricular tachycardia|
|US5412854||18 juin 1993||9 mai 1995||Humphrey Instruments, Inc.||Method of making a high frequency focused transducer|
|US5456259||30 juil. 1992||10 oct. 1995||Intravascular Research Limited||Ultrasonic transducer arrangement and catheter|
|US5590657||6 nov. 1995||7 janv. 1997||The Regents Of The University Of Michigan||Phased array ultrasound system and method for cardiac ablation|
|US5630837 *||31 mars 1995||20 mai 1997||Boston Scientific Corporation||Acoustic ablation|
|US5951304||21 mai 1997||14 sept. 1999||General Electric Company||Fanout interconnection pad arrays|
|US6117101||25 nov. 1998||12 sept. 2000||The Regents Of The University Of California||Circumferential ablation device assembly|
|US6206831 *||6 janv. 1999||27 mars 2001||Scimed Life Systems, Inc.||Ultrasound-guided ablation catheter and methods of use|
|US6245064||11 janv. 2000||12 juin 2001||Atrionix, Inc.||Circumferential ablation device assembly|
|US6254599||22 mars 1999||3 juil. 2001||Atrionix, Inc.||Circumferential ablation device assembly|
|US6392330||5 juin 2000||21 mai 2002||Pegasus Technologies Ltd.||Cylindrical ultrasound receivers and transceivers formed from piezoelectric film|
|US6488630||17 févr. 2000||3 déc. 2002||Imperial College Innovations Limited||Arrays of quasi-randomly distributed ultrasound transducers|
|US6497667||31 juil. 2001||24 déc. 2002||Koninklijke Philips Electronics N.V.||Ultrasonic probe using ribbon cable attachment system|
|US6500174||5 nov. 1999||31 déc. 2002||Atrionix, Inc.||Circumferential ablation device assembly and methods of use and manufacture providing an ablative circumferential band along an expandable member|
|US6508775||20 mars 2001||21 janv. 2003||Pharmasonics, Inc.||High output therapeutic ultrasound transducer|
|US6514249||2 mars 2000||4 févr. 2003||Atrionix, Inc.||Positioning system and method for orienting an ablation element within a pulmonary vein ostium|
|US6527769||25 févr. 2002||4 mars 2003||Atrionix, Inc.||Tissue ablation system and method for forming long linear lesion|
|US20020062079||16 nov. 2001||23 mai 2002||Nihon Dempa Kogyo Co., Ltd.||Composite type ultrasonic probe and a method of manufacturing the same|
|US20020089262||21 déc. 2001||11 juil. 2002||Minoru Topa||Cylindrical transducer apparatus|
|US20020175591||20 févr. 2002||28 nov. 2002||Hans-Jurgen Schreiner||Process for the manufacture of piezoceramic multilayer actuators|
|US20030013968||13 juil. 2001||16 janv. 2003||Todd Fjield||Ultrasonic transducers|
|Brevet citant||Date de dépôt||Date de publication||Déposant||Titre|
|US7822453||26 oct. 2010||Nellcor Puritan Bennett Llc||Forehead sensor placement|
|US8072163||21 oct. 2009||6 déc. 2011||General Electric Company||Knowledge-based driver apparatus for high lumen maintenance and end-of-life adaptation|
|US8257274||4 sept. 2012||Nellcor Puritan Bennett Llc||Medical sensor and technique for using the same|
|US8364220||25 sept. 2008||29 janv. 2013||Covidien Lp||Medical sensor and technique for using the same|
|US8412297||28 juil. 2006||2 avr. 2013||Covidien Lp||Forehead sensor placement|
|US8515515||11 mars 2010||20 août 2013||Covidien Lp||Medical sensor with compressible light barrier and technique for using the same|
|US8702609||16 mai 2008||22 avr. 2014||Meridian Cardiovascular Systems, Inc.||Image-guided intravascular therapy catheters|
|US8779689||13 déc. 2010||15 juil. 2014||General Electric Company||Ramp controlled driver for series/parallel solid state lighting devices|
|US8781548||11 mars 2010||15 juil. 2014||Covidien Lp||Medical sensor with flexible components and technique for using the same|
|US8880185||25 juin 2013||4 nov. 2014||Boston Scientific Scimed, Inc.||Renal denervation and stimulation employing wireless vascular energy transfer arrangement|
|US8939970||29 févr. 2012||27 janv. 2015||Vessix Vascular, Inc.||Tuned RF energy and electrical tissue characterization for selective treatment of target tissues|
|US8951251||7 nov. 2012||10 févr. 2015||Boston Scientific Scimed, Inc.||Ostial renal nerve ablation|
|US8974451||25 oct. 2011||10 mars 2015||Boston Scientific Scimed, Inc.||Renal nerve ablation using conductive fluid jet and RF energy|
|US9023034||22 nov. 2011||5 mai 2015||Boston Scientific Scimed, Inc.||Renal ablation electrode with force-activatable conduction apparatus|
|US9028472||21 déc. 2012||12 mai 2015||Vessix Vascular, Inc.||Methods and apparatuses for remodeling tissue of or adjacent to a body passage|
|US9028485||23 sept. 2011||12 mai 2015||Boston Scientific Scimed, Inc.||Self-expanding cooling electrode for renal nerve ablation|
|US9037259||21 déc. 2012||19 mai 2015||Vessix Vascular, Inc.||Methods and apparatuses for remodeling tissue of or adjacent to a body passage|
|US9050106||21 déc. 2012||9 juin 2015||Boston Scientific Scimed, Inc.||Off-wall electrode device and methods for nerve modulation|
|US9060761||9 nov. 2011||23 juin 2015||Boston Scientific Scime, Inc.||Catheter-focused magnetic field induced renal nerve ablation|
|US9072902||21 déc. 2012||7 juil. 2015||Vessix Vascular, Inc.||Methods and apparatuses for remodeling tissue of or adjacent to a body passage|
|US9079000||16 oct. 2012||14 juil. 2015||Boston Scientific Scimed, Inc.||Integrated crossing balloon catheter|
|US9084609||18 juil. 2011||21 juil. 2015||Boston Scientific Scime, Inc.||Spiral balloon catheter for renal nerve ablation|
|US9089350||9 nov. 2011||28 juil. 2015||Boston Scientific Scimed, Inc.||Renal denervation catheter with RF electrode and integral contrast dye injection arrangement|
|US9119600||15 nov. 2012||1 sept. 2015||Boston Scientific Scimed, Inc.||Device and methods for renal nerve modulation monitoring|
|US9119632||16 nov. 2012||1 sept. 2015||Boston Scientific Scimed, Inc.||Deflectable renal nerve ablation catheter|
|US9125666||28 sept. 2007||8 sept. 2015||Vessix Vascular, Inc.||Selectable eccentric remodeling and/or ablation of atherosclerotic material|
|US9125667||18 oct. 2007||8 sept. 2015||Vessix Vascular, Inc.||System for inducing desirable temperature effects on body tissue|
|US9155589||22 juil. 2011||13 oct. 2015||Boston Scientific Scimed, Inc.||Sequential activation RF electrode set for renal nerve ablation|
|US9162046||28 sept. 2012||20 oct. 2015||Boston Scientific Scimed, Inc.||Deflectable medical devices|
|US9173696||17 sept. 2013||3 nov. 2015||Boston Scientific Scimed, Inc.||Self-positioning electrode system and method for renal nerve modulation|
|US9174050||21 déc. 2012||3 nov. 2015||Vessix Vascular, Inc.||Methods and apparatuses for remodeling tissue of or adjacent to a body passage|
|US9186209||20 juil. 2012||17 nov. 2015||Boston Scientific Scimed, Inc.||Nerve modulation system having helical guide|
|US9186210||10 oct. 2012||17 nov. 2015||Boston Scientific Scimed, Inc.||Medical devices including ablation electrodes|
|US9186211||25 janv. 2013||17 nov. 2015||Boston Scientific Scimed, Inc.||Methods and apparatuses for remodeling tissue of or adjacent to a body passage|
|US9192435||22 nov. 2011||24 nov. 2015||Boston Scientific Scimed, Inc.||Renal denervation catheter with cooled RF electrode|
|US9192790||13 avr. 2011||24 nov. 2015||Boston Scientific Scimed, Inc.||Focused ultrasonic renal denervation|
|US9204993 *||15 janv. 2013||8 déc. 2015||Empire Technology Development Llc||Treatment of diverticula|
|US9220558||26 oct. 2011||29 déc. 2015||Boston Scientific Scimed, Inc.||RF renal denervation catheter with multiple independent electrodes|
|US9220561||19 janv. 2012||29 déc. 2015||Boston Scientific Scimed, Inc.||Guide-compatible large-electrode catheter for renal nerve ablation with reduced arterial injury|
|US9265969||10 déc. 2012||23 févr. 2016||Cardiac Pacemakers, Inc.||Methods for modulating cell function|
|US9277955||11 avr. 2011||8 mars 2016||Vessix Vascular, Inc.||Power generating and control apparatus for the treatment of tissue|
|US9297845||4 mars 2014||29 mars 2016||Boston Scientific Scimed, Inc.||Medical devices and methods for treatment of hypertension that utilize impedance compensation|
|US9326751||14 nov. 2011||3 mai 2016||Boston Scientific Scimed, Inc.||Catheter guidance of external energy for renal denervation|
|US9327100||12 mars 2013||3 mai 2016||Vessix Vascular, Inc.||Selective drug delivery in a lumen|
|US9358365||30 juil. 2011||7 juin 2016||Boston Scientific Scimed, Inc.||Precision electrode movement control for renal nerve ablation|
|US9364284||10 oct. 2012||14 juin 2016||Boston Scientific Scimed, Inc.||Method of making an off-wall spacer cage|
|US20090030312 *||16 mai 2008||29 janv. 2009||Andreas Hadjicostis||Image-guided intravascular therapy catheters|
|US20110089853 *||21 avr. 2011||General Electric Company||Electronic driver apparatus for large area solid-state leds|
|US20110089855 *||21 avr. 2011||General Electric Company||Knowledge-based driver apparatus for high lumen maintenance and end-of-life adaptation|
|US20120302888 *||29 nov. 2012||The Hong Kong Polytechnic University||Array ultrasound endoscopic probe, a manufacture method thereof and a fixing and rotating device|
|US20140088629 *||20 sept. 2013||27 mars 2014||Boston Scientific Scimed, Inc.||System for nerve modulation and innocuous thermal gradient nerve block|
|US20140200479 *||15 janv. 2013||17 juil. 2014||Empire Technology Development Llc||Treatment of diverticula|
|Classification aux États-Unis||606/27, 606/28|
|Classification internationale||A61B17/22, A61B19/00, A61B18/18, A61B8/12|
|Classification coopérative||A61B8/4483, A61B17/2202, A61B8/4488, A61B8/445, A61B8/12, A61B2090/3782|
|Classification européenne||A61B8/44R2, A61B8/12, A61B8/44N2, A61B8/44R|
|15 oct. 2003||AS||Assignment|
Owner name: PIEZO TECHNOLOGIES, INC., INDIANA
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:BROSCH, JARED;HADJICOSTIS, ANDREAS;REEL/FRAME:014618/0724
Effective date: 20031005
|2 mars 2010||FPAY||Fee payment|
Year of fee payment: 4
|6 juin 2013||AS||Assignment|
Owner name: PIEZOTECH, LLC, INDIANA
Free format text: CORRECTIVE ASSIGNMENT TO CORRECT THE IDENTIFICATION OF THE ASSIGNEE BY ITS LEGAL NAME OF PIEZOTECH,LLC PREVIOUSLY RECORDED ON REEL 014618 FRAME 0724. ASSIGNOR(S) HEREBY CONFIRMS THE ASSIGNMENT TO PIEZOTECH, LLC;ASSIGNORS:BROSCH, JARED;HADJICOSTIS, ANDREAS;REEL/FRAME:030572/0244
Effective date: 20031005
|5 mars 2014||FPAY||Fee payment|
Year of fee payment: 8